www.floridavitrectomy.comMACULAR DEGENERATION
Macular degeneration, also known as age-related macular degeneration (AMD), is caused by deterioration of the retina and can severely impair vision. There is no cure for macular degeneration, but it can be treated with vitamins, laser therapy, medications, and vision aids.
Macular degeneration facts
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The macula is in the center of the retina, the light-sensitive layer of tissue at the back of the eye. The macula is responsible for central vision (straight-ahead vision). Degeneration of the macula occurs most often after the age of 60 years and is termed age-related macular generation (AMD).
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AMD is a painless condition.
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There are two types of AMD: dry AMD and wet AMD.
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Smoking, high blood pressure, obesity, a diet high in unsaturated fats and simple carbohydrates and lack of exercise all increase the risk of AMD.
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Early symptoms of dry AMD include slightly blurred vision, the need for more light for reading, and difficulty recognizing faces until very close to the person. A symptom of more advanced dry AMD is the presence of a blurred spot in the center of vision. An early symptom of wet AMD is the wavy appearance of straight lines.
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Dry AMD cannot be treated at present, but progression can be slowed through a healthy lifestyle and sometimes with antioxidant vitamins. Injections into the eye of anti-angiogenic agents are successfully being used in arresting or slowing wet AMD. Because of new therapies for the wet form of AMD, early diagnosis of wet AMD is particularly essential.
Risk Factors
Commonly named risk factors for developing macular degeneration include:
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Aging. The prevalence of AMD increases with age. In the United States, approximately one in 14 people over the age of 40 has some degree of macular degeneration. For those over 60, the rate is one in eight (12.5 percent); and for seniors over age 80, one in three (33 percent) has AMD.
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Obesity and inactivity. Overweight patients with macular degeneration had more than double the risk of developing advanced forms of macular degeneration compared with people of normal body weight, according to one study reported in Archives of Ophthalmology (June 2003). In the same study, those who performed vigorous activity at least three times weekly reduced their risk of developing advanced AMD, compared with inactive patients.
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Heredity. As stated above, recent studies have found that specific variants of different genes are present in most people who have macular degeneration. Studies of fraternal and identical twins may also demonstrate that heredity is a factor in who develops AMD and how severe it becomes.
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High blood pressure (hypertension). Investigative Ophthalmology and Vision Science reported the results of a European study demonstrating that high blood pressure may be associated with development of macular degeneration (September 2003).
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Smoking. Smoking is a major AMD risk factor and was found in one British study to be directly associated with about 25 percent of AMD cases causing severe vision loss.
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Lighter eye color. Because macular degeneration long has been thought to occur more often among Caucasian populations, particularly in people with light skin color and eye color, some researchers theorized that the extra pigment found in darker eyes was a protective factor against development of the eye disease during sun exposure. But no conclusive evidence as yet has linked excessive sun exposure to development of AMD.
Treatment
There is as yet no outright cure for age-related macular degeneration, but some treatments may delay its progression or even improve vision.
Treatments for macular degeneration depend on whether the disease is in its early-stage, dry form or in the more advanced, wet form that can lead to serious vision loss. No FDA-approved treatments exist yet for dry macular degeneration, although nutritional intervention may help prevent its progression to the wet form.
Stages of Macular Degeneration
There are three stages of Age-related Macular Degeneration (AMD).
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Early AMD – Most people do not experience vision loss in the early stage of AMD, which is why regular eye exams are important, particularly if you have more than one risk factor (see below). Early AMD is diagnosed by the presence of medium-sized drusen (yellow deposits beneath the retina).
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Intermediate AMD – At this stage, there may be some vision loss, but there still may not be noticeable symptoms. A comprehensive eye exam with specific tests will look for larger drusen and/or pigment changes in the retina.
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Late AMD – At this stage, vision loss has become noticeable.
Complications
Progression to wet macular degeneration is the main complication of dry age-related macular degeneration. At any time, dry macular degeneration can progress to the more severe form of the disease called wet macular degeneration, which may cause rapid vision loss. There is no accurate way to predict who will eventually develop wet macular degeneration.
Other eye diseases such as cataracts, glaucoma, retinal detachment, or dry eyes are not complications of macular degeneration. Patients with macular degeneration can, however, develop these or other eye diseases and people with these conditions can also develop AMD concurrently.
Prognosis
Macular degeneration in its advanced form can cause loss of all central vision in both eyes. In the absence of other eye diseases, peripheral vision is maintained. Therefore, patients with advanced macular degeneration are, in most cases, able to see enough to get around within familiar surroundings.
The use of magnifying devices can often improve vision in macular degeneration to allow for reading or watching of television.
